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Organization
DENTAL ASSOCIATES OF NORTHERN VIRGINIA FAIRFAX, PLLC
Active
Organization
DENTAL ASSOCIATES OF NORTHERN VIRGINIA FAIRFAX, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(941) 955-3150
Entity
Organization
Contact information
Practice address
5417 BACKLICK RD, SUITE D, SPRINGFIELD, VA 22151-3915
(703) 750-9404
Mailing address
5417 BACKLICK RD, SUITE D, SPRINGFIELD, VA 22151-3915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
VA
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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